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Utilization Review Manager Jobs in Nevada (NOW HIRING)

Acadia Healthcare

Director of Utilization

Henderson, NV · On-site

Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...

Acadia Healthcare

Director of Utilization

Henderson, NV · On-site

Direct and manage the day-to-day operations of the Utilization Review department. ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility while maximizing ...

Acadia Healthcare

Utilization Specialist

Henderson, NV · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Acadia Healthcare

Utilization Specialist

Henderson, NV · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Nevada

Utilization Review Manager information

See Nevada salary details

$39.7K

$92.7K

$170.6K

How much do utilization review manager jobs pay per year?

As of Aug 12, 2026, the average yearly pay for utilization review manager in Nevada is $92,677.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,600.00 and $111,500.00 per year, depending on experience, location, and employer.

Is utilization review a stressful job?

Utilization review managers oversee the assessment of healthcare services to ensure appropriate and efficient care, which can involve high workloads and strict deadlines, leading to stress. The job requires strong organizational skills, attention to detail, and the ability to handle complex cases, which may contribute to job-related stress for some individuals.

What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What are the key skills and qualifications needed to thrive as a utilization review manager?

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

What does a utilization review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.
What are the most commonly searched types of Utilization Review jobs in Nevada? The most popular types of Utilization Review jobs in Nevada are:
What are popular job titles related to Utilization Review Manager jobs in Nevada? For Utilization Review Manager jobs in Nevada, the most frequently searched job titles are:
What job categories do people searching Utilization Review Manager jobs in Nevada look for? The top searched job categories for Utilization Review Manager jobs in Nevada are:
What cities in Nevada are hiring for Utilization Review Manager jobs? Cities in Nevada with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Nevada as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $92,677 per year, or $44.6 per hour.

Per Diem Utilization Review Nurse

University Medical Center of Southern Nevada

Las Vegas, NV

$59.13/hr

Full-time, Per diem

Medical, Retirement

Re-posted 26 days ago

University Medical Center Of Southern Nevada rating

7.2

Company rating: 7.2 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

428th of 1,058 rated hospitals

Job description

Position Summary EMPLOYER-PAID PENSION PLAN (NEVADA PERS) COMPETITIVE SALARY & BENEFITS PACKAGE As an academic medical center with a rich history of providing life-saving treatment in Southern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada's highest level of care to promote successful medical outcomes for patients. UMC is home to Nevada's ONLY Nonprofit Level I Trauma Center, Verified Burn Center, and Multi-Organ Transplant Center. In 2026, we became the FIRST and ONLY Magnet-Recognized hospital in the state, reflecting UMC's nursing professionalism, teamwork, and superiority in patient care.

***Per Diem Opening(s)*** THIS POSITION MAY CLOSE WITHOUT NOTICE ONCE A SUFFICIENT NUMBER OF QUALIFIED APPLICATIONS ARE RECEIVED. Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third party payer requirements. Duties include analyzing medical charts, determining whether care provided is within established parameters.

Job Requirement Education/Experience: Graduation from an accredited school of nursing and five (5) years of acute hospital clinical nursing experience, one (1) year of which was in Utilization Management, Case Management, or Clinical Documentation Improvement. Licensing/Certification Requirements: Valid license by the State of Nevada to practice as a Registered Nurse. Additional Position Requirements Minimum three (3) years of Utilization Management experience.

Minimum of three (3) year's experience with discharge planning in an acute care facility. Recent documented experience with InterQual, and ability to pass the InterQual exam. Recent documented experience with Milliman experience.

Knowledge, Skills, Abilities, and Physical Requirements Knowledge of: Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies and procedures; Joint Commission Accredited Health care Organizations standards, state statutes governing hospital services and health care, and other relevant regulations and standards; clinical medical and nursing procedures; disease processes; department and hospital safety practices and principles; patient rights; age specific patient care practices; infection control policies and practices; department and hospital emergency response policies and procedures. Skill in: Interpreting patient charts to determine whether care given is within best practice, appropriate for the diagnosis and properly documented; excellent ability to collaborate, co-ordinate and communicate findings; interpreting regulations and standards for others; writing reports, meeting minutes and other technical documents; analyzing statistical and other quantitative data; applying investigative and interviewing techniques; using a computer and a variety of software applications; communicating with a wide variety and establishing interpersonal relationships to interact effectively with co-workers, supervisor, staff in other work units and exchange or convey information. Physical Requirements and Working Conditions: Mobility to work in a typical office setting and use standard equipment, stamina to remain seated for extended periods of time, vision to read printed materials and a computer screen, and hearing and speech to communicate effectively in person and over the telephone.

Strength and agility to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. May work shifts and weekends. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.

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